Date Presented 04/21/2023

Students expressed difficulties implementing occupation-based practice (OBP) on Level II fieldwork and requested opportunities for interactive learning, examples of OBP, and focus on occupation-based instruction to facilitate their education in OBP.

Primary Author and Speaker: Mackenzie L. Walker

Additional Authors and Speakers: Amanda K. Giles

PURPOSE: Occupation-based practice (OBP) is in effect when engagement in occupation is the primary means for evaluation, intervention, and outcomes (Fisher, 2013). Recently graduated occupational therapists do not feel prepared to implement OBP due to lack of consensus among educators about OBP, exposure to OBP, and clinical reasoning skills to effectively implement OBP (Di Tommaso et al., 2019; Psillas & Stav, 2021). This study aimed to explore student understanding of, exposure to, and implementation of OBP as well as perception of the use of video to facilitate education regarding OBP.

DESIGN: This study utilized a mixed-method design with a convenience sample of 25 OTD students enrolled in Level II Fieldwork.

METHOD: Using an anonymous and optional REDCap survey, quantitative data was collected via eleven 5-point Likert scale items and one multi-select item, and qualitative data was collected via one open-ended question. Data was analyzed using descriptive statistics and thematic analysis with dual reviewers.

RESULTS: Students identified difficulties implementing OBP on Level II Fieldwork (80%, n = 20), including limited resources, expectations of productivity, and exposure to OBP. Students reported they would have benefited from more exposure to OBP in didactic coursework (84%, n = 21) and on Level II fieldwork (52%, n = 13). Case-based video learning was identified as a helpful tool for understanding and implementing OBP (80%, n = 20). Themes included three recommendations: opportunities for interactive learning (44%, n = 11), examples of OBP (40%, n = 10), and focus on occupation-based instruction (24%, n = 6).

CONCLUSION: Although students generally understood and valued the use of OBP, they reported difficulties implementing OBP on their Level II Fieldwork and expressed they would have benefited from more exposure to OBP.

IMPACT STATEMENT: Case-based video learning in occupational therapy curricula is a promising avenue to address student preparedness to implement OBP.


Di Tommaso, A., Wicks, A., Scarvell, J., & Isbel, S. (2019). Experiences of occupation-based practice: An Australian phenomenological study of recently graduated occupational therapists. The British Journal of Occupational Therapy, 82(7), 412–421.

Fisher, A. G. (2013). Occupation-centred, occupation-based, occupation-focused: Same, same or different? Scandinavian Journal of Occupational Therapy, 20(3), 162–173.

Psillas, S. M., & Stav, W. B. (2021). Development of the Dynamic Model of Occupation-Based Practice. The Open Journal of Occupational Therapy, 9(4), 1–14.